Investigating the Impacts of Preoperative Steroid Treatment on Tumor Necrosis Factor-Alpha and Duration of Extubation Time underwent Ventricular Septal Defect Surgery

Hh, Poyrazoğlu; Duman, Zeynel; Demir, Şerafettin; Mk, Avşar; Atalay, Atakan; Ciftci, B.; Bayraktar, Ihsan; F, Tor

doi:10.5152/balkanmedj.2016.16379

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…The longer the duration of extubation (the amount of time the breathing tube is in place), the higher the risk of postoperative delirium [ 38 , 39 ]. This is because the tube can cause irritation and inflammation in the airways, which can trigger an inflammatory response in the body that can lead to cognitive issues [ 40 , 41 ]. A study looked at the relationship between extubation duration and postoperative delirium in elderly patients undergoing cardiopulmonary bypass.…”

Section: Discussionmentioning

confidence: 99%

The role of perioperative sedative anesthetics in preventing postoperative delirium: a systematic review and network-meta analysis including 6679 patients

Huang,

Zhang,

Wang

et al. 2024

BMC Cardiovasc Disord

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Objective Postoperative delirium is a common and debilitating complication that significantly affects patients and their families. The purpose of this study is to investigate whether there is an effective sedative that can prevent postoperative delirium while also examining the safety of using sedatives during the perioperative period. Methods The net-meta analysis was used to compare the incidence of postoperative delirium among four sedatives: sevoflurane, propofol, dexmedetomidine, and midazolam. Interventions were ranked according to their surface under the cumulative ranking curve (SUCRA). Results A total of 41 RCT studies involving 6679 patients were analyzed. Dexmedetomidine can effectively reduce the incidence of postoperative delirium than propofol (OR 0.47 95% CI 0.25–0.90), midazolam (OR 0.42 95% CI 0.17-1.00), normal saline (OR 0.42 95% CI 0.33–0.54) and sevoflurane (OR 0.39 95% CI 0.18–0.82). The saline group showed a significantly lower incidence of bradycardia compared to the group receiving dexmedetomidine (OR 0.55 95% CI 0.37–0.80). In cardiac surgery, midazolam (OR 3.34 95%CI 2.04–5.48) and normal saline (OR 2.27 95%CI 1.17–4.39) had a higher rate of postoperative delirium than dexmedetomidine, while in non-cardiac surgery, normal saline (OR 1.98 95%CI 1.44–2.71) was more susceptible to postoperative delirium than dexmedetomidine. Conclusion Our analysis suggests that dexmedetomidine is an effective sedative in preventing postoperative delirium whether in cardiac surgery or non-cardiac surgery. The preventive effect of dexmedetomidine on postoperative delirium becomes more apparent with longer surgical and extubation times. However, it should be administered with caution as it was found to be associated with bradycardia.

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Section: Discussionmentioning

confidence: 99%

The role of perioperative sedative anesthetics in preventing postoperative delirium: a systematic review and network-meta analysis including 6679 patients

Huang,

Zhang,

Wang

et al. 2024

BMC Cardiovasc Disord

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“…Several methods have been employed to decrease this inflammatory response. The effect of prophylactic corticosteroid infusion during CPB on inflammatory response and on postoperative course is controversial [7,8]. Other pharmacologic agents are also used in practice and at the experimental level.…”

Section: Introductionmentioning

confidence: 99%

The effect of dexmedetomidine on the inflammatory response in children undergoing repair of congenital heart disease: a randomized controlled clinical trial

Abdelrahman

Hassan

Mohammed

et al. 2020

Egyptian Journal of Anaesthesia

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Background: The inflammatory response due to cardiopulmonary bypass (CBP) activates different inflammatory pathways that affect multiple organs. Dexmedetomidine is proved to affect inflammatory marker production. Objectives: Evaluation of the effect of Dexmedetomidine on the inflammatory response associated with pediatric open-heart surgery using interleukin-6 (IL-6) and interferon-gamma (INF-ɤ) levels. Methods: 61children aged between one to 8 years undergoing elective repair of non-cyanotic congenital heart disease with CPB were randomly assigned into two groups. The control group (31 patients) received normal saline, whereas the Dex group (30 patients) received an initial bolus of Dexmedetomidine 0.5 µg/kg followed immediately by infusion of 0.5 µg/kg/hr continued till the end of CPB. The level of IL-6 and INF-ɤ was measured. Hemodynamic, ICU, and hospital data were recorded. Results: IL-6 and INF-ɤ levels were increased significantly with time in control group, with no increase in their levels in the Dex group. They were significantly lower in the Dex group compared to the control group in samples taken during bypass, 6 h and 24 h after the operation (the end of surgical procedure). There was a significant difference between the groups regarding inotropic score and mechanical ventilation. There was no significant difference between the groups regarding complications, duration of ICU or hospital stay. Conclusion: The use of Dexmedetomidine in pediatric cardiac surgery for non-cyanotic heart disease had significantly attenuated the inflammatory response. It was useful in decreasing the level of inflammatory mediators, inotropic support, and duration of mechanical ventilation, but not the ICU or hospital stay. Trial registration: https://clinicaltrials.gov. (Identifier: NCT03163238).

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Prophylactic corticosteroids for paediatric heart surgery with cardiopulmonary bypass

Gibbison

Villalobos-Lizardi

Martínez

et al. 2020

Cochrane Database of Systematic Reviews

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This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the benefits and harms of prophylactic corticosteroids in children between birth and 18 years of age undergoing cardiac surgery with cardiopulmonary bypass. B A C K G R O U N D Description of the condition Paediatric heart surgery outcomes have improved markedly over time as a result of marginal gains in training, technology and safety systems (Brown 2015; Hoashi 2015; Jacobs 2016; NICOR 2016). This improvement has been particularly notable in the last 20 years: the publication of heart surgery outcomes after the Kennedy Inquiry in the UK has been associated with a large increase in survival for risk-adjusted surgery (Kennedy 2001; Grant 2013). This has been mirrored worldwide (Brown 2015; Hoashi 2015; Jacobs 2016). One area where there is still controversy is corticosteroid use. Paediatric heart surgery with the use of cardiopulmonary bypass results in a systemic inflammatory response; corticosteroids have been widely used to mitigate the potential deleterious effects of this response. The surgical intervention for which corticosteroids are used includes a variety of surgeries performed on the heart and great vessels. In most cases this procedure aims to correct congenital heart diseases (i.e. heart malformations that the child is born with). In most cases (78% in the UK) (NICOR 2016), surgery will take place with the use Cardio-Pulmonary By-1 Prophylactic corticosteroids for paediatric heart surgery with cardiopulmonary bypass (Protocol)

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Investigating the Impacts of Preoperative Steroid Treatment on Tumor Necrosis Factor-Alpha and Duration of Extubation Time underwent Ventricular Septal Defect Surgery

Cited by 3 publications

References 24 publications

The role of perioperative sedative anesthetics in preventing postoperative delirium: a systematic review and network-meta analysis including 6679 patients

The role of perioperative sedative anesthetics in preventing postoperative delirium: a systematic review and network-meta analysis including 6679 patients

The effect of dexmedetomidine on the inflammatory response in children undergoing repair of congenital heart disease: a randomized controlled clinical trial

Prophylactic corticosteroids for paediatric heart surgery with cardiopulmonary bypass

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